Three months after a persistent, “festering” problem of “dirty instruments” forced the suspension of surgeries, operations continue to be disrupted at HCA Florida North Florida Hospital in Gainesville. 

As recently as Thursday surgeries were canceled even as some patients were being prepped for their operations. Sources in positions to know told Mainstreet that a shortage of surgical instruments was the chief—but not only—problem.  

Another source told the University of Florida’s Fresh Take Florida that operating room staff last week went through “as many as 10 trays” of surgical tools in one case, trying to find instruments that were not “compromised.” 

Several surgeons, described as “mad as hornets,” confronted the hospital administration Thursday morning after some or all of their operations were canceled for the day. Doctors were told Thursday night to expect disruptions again Friday, because, a source said, it takes a day or two to repackage and re-sterilize instruments. 

On Saturday, North Florida Hospital’s chief medical officer, Dr. Sherrie Somers, replied to a text message from Mainstreet saying, “Respectfully, I need to direct you back to our communication specialists. Have a great day!” 

John “Trip” Farmer, a spokesperson for the hospital and its parent company, HCA Healthcare, Inc., would not respond specifically to questions about ongoing disruptions or their causes last week, writing only that, “As we have shared previously, we have resumed surgeries.” The company reiterated its insistence that the hospital’s goal is to provide excellent patient care and again cited accreditations and awards received from healthcare organizations. 

As Mainstreet previously reported, the hospital’s persistent problems with blood, tissue and other matter clinging to instruments delivered to operating rooms had been going on for “at least a year” when the issue came to a head in January. In a Jan. 12 internal email, Somers—who took her position in August—acknowledged that the hospital had made unfulfilled promises to doctors for “6-12 months.” 

The hospital suspended all surgeries on Jan. 17, even instructing Alachua County Fire Rescue to take the critically sick or injured somewhere else. That directive was lifted the next day, but the hospital’s operating rooms went dark to all but emergency surgeries for some three weeks.   

Operations resumed Feb. 5, but only for critical cases. Surgeons’ requests were triaged. Even critical cases could be rejected by a “physician advisory panel.” 

Internal hospital documents obtained by Mainstreet corroborate and expand on information received from sources, most of whom spoke to Mainstreet under the condition of anonymity for fear of retaliation.  

“These people can be very vindictive,” a surgeon said. “I can’t feed my family if I don’t operate, and they decide who gets to operate.” 

The hospital called in Steris Corporation, a company approved for federal disaster response, to clean and repair “probably thousands” of surgical instruments, according to a technician who spoke to Mainstreet. Steris supervisors and “educators” set out to train existing hospital staff how to do their jobs correctly.  

On Friday, technicians in green scrub suits were still working in a Steris “Mobile Central Sterilization Department”—the size of a semi-tractor trailer truck—set up behind the emergency room. 

HCA North Florida Hospital announced on March 13 that it had “resumed full operations” after installing additional equipment, adding staff in its sterilization department, and buying new surgical instruments. 

But the next week, installation of a new water filtration system caused complications that left surgical instruments smeared with a black or orange residue—which could be seen in photos reviewed by Mainstreet.  

Sources told Mainstreet that new staff included inexperienced, unqualified technicians to work in the sterilization department with “on the job training.” 

A “disconnect” between upper management and “line personnel” resulted in large numbers of out-of-date instruments being discarded before new ones could be brought into service, a source said Friday. 

A person in a position to know told Mainstreet that one surgeon resorted to “hoarding” instruments last week to make it through the day.  

The source said older instruments, which might have pockmarks or other blemishes on them, were “thrown out” before replacements—“stacks of them”—could be prepared for use. It was a case of “the right hand not knowing what the left hand was doing,” the person said. 

A source told Fresh Take Florida that hospital staff delivered “compromised” instruments to operating rooms on Thursday in numbers so large that tray after tray had to be set aside. The person explained that once the seal is broken on a tray of instruments holding even one that is contaminated, none on that tray can be used.  

On Feb. 6, Florida’s Agency for Health Care Administration (AHCA) was on site investigating complaints related to the hospital’s operating rooms, but in an inspection “status report posted online Feb. 29, the agency said it found “no deficiencies.” The brief report included no details of the one-day inspection.  

The extent to which the investigation is ongoing is unclear. AHCA and other regulatory agencies are limited by statutes and rules as to what they can reveal publicly and have declined repeated requests for more information.  

Editor’s note: This story is the product of a joint investigation between Mainstreet Daily News and Fresh Take Florida, a news service operated by the University of Florida College of Journalism and Communications. If you or someone you know has been affected by the surgery disruptions at HCA Florida North Florida Hospital, email editor@mainstreetdailynews.com or call 352-313-3192.